Covid Gives Another Serious Attack, This Time Attacking Your Sanity
Talking about Covid19, it seems that the cycle keeps repeating itself especially in Indonesia. Positive rate is gradually increasing, vice versa, hospital’s bed capacity is not improving and started to fall. This is truly devastating truth and Covid19 never let us to be relieved, not even a single day. A week ago, scientists have found a major issue in Covid19’s patient, delirium has reported as one of Covid19’s side effects.
What is Delirium?
Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. It allows you to experience an abrupt change in the brain that causes mental confusion and emotional disruption. It makes it difficult to think, remember, sleep, pay attention, and more. The start of delirium is usually rapid — within hours or a few days. They often fluctuate throughout the day, and there may be periods of no symptoms. Symptoms tend to be worse during the night when it’s dark and things look less familiar.
What causes delirium?
When you have trouble breathing due to asthma or another condition, your brain doesn’t get the oxygen it needs. Any condition or factor that significantly changes your brain function can cause severe mental confusion, triggering delirium to occur.
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Diseases that cause inflammation and infection, such as pneumonia, lack of oxygen, can interfere with brain function. Additionally, taking certain medications such as blood pressure medicine or misusing drugs can disrupt chemicals in the brain.
Alcohol withdrawal and eating or drinking poisonous substances can also cause delirium.
Take a look at yourself
Primary signs and symptoms include those below.
Awareness of the environment is reduced significantly
This may result in:
- An inability to stay focused on a topic or to switch topics
- Getting stuck on an idea rather than responding to questions or conversation
- Being easily distracted by unimportant things
- Being withdrawn, with little or no activity or little response to the environment
Cognitive Impairment
This may trigger as:
- Poor memory, particularly of recent events
- Disorientation — for example, not knowing where you are or who you are
- Difficulty speaking or recalling words
- Rambling or nonsense speech
- Trouble understanding speech
- Difficulty reading or writing
Changes of Behaviour
These may include:
- Seeing things that don’t exist (hallucinations)
- Restlessness, agitation or combative behavior
- Calling out, moaning or making other sounds
- Being quiet and withdrawn — especially in older adults
- Slowed movement or lethargy
- Disturbed sleep habits
- Reversal of night-day sleep-wake cycle
Emotional disturbances
These may appear as:
- Anxiety, fear or paranoia
- Depression
- Irritability or anger
- A sense of feeling elated (euphoria)
- Apathy
- Rapid and unpredictable mood shifts
- Personality changes
Delirium can be a life-threatening emergency. Affected patients require an appropriate evaluation with history taking, physical, and neurologic examination and laboratory tests.
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Physical examination should evaluate head-to-toe and vital signs to determinate any possible cause. Neurologic examination should focus on evaluating new focal findings that suggest an intracranial cause, for example, a stroke. Delirium is a very common disorder seen in hospitalized patients. Its diagnosis and management are very complex and best done with an interprofessional team that includes a neurologist, psychiatrist, internist, intensivist, and ICU nurses. Nurses are often the first to detect the presence of delirium and should communicate as soon as possible with the team; because the sooner the condition is managed, the better the outcomes. At the same time, the nurses should maintain a quiet environment for the patient, ensure patient safety, and communicate with the patient and family.